1. Field of the Invention
This invention relates to minimally invasive surgery. More specifically, it relates to an attachment apparatus for the placement, attachment, and removal of a surgical device.
2. Description of the Prior Art
Minimally Invasive Surgery (MIS) is done through small incisions. For patients, MIS means less trauma to the body, less blood loss, smaller surgical scars, less need for pain medication, and shorter hospital stays. In recently developed MIS techniques (e.g., Natural Orifice Transluminal Endoscopic Surgery (NOTES) and Laparo-Endoscopic Single Site (LESS) surgery), “scarless” abdominal operations are performed with multiple endoscopic tools passing through a multiport trocar inserted in a natural body orifice (such as the umbilicus). Each year thousands of patients enjoy the benefits of these types of non-open surgeries.
While there are many benefits, these surgeries often take longer to perform than equivalent open surgeries, which results in additional patient risk to contamination. Additionally, LESS surgery creates a bottleneck for surgical tools through the four ports of the trocar where graspers, cutters, videoscopes, and insufflation tubes all compete for the limited number of trocar ports.
In order to eliminate this bottleneck, a family of insertable surgical modules has been proposed. The first member of the family is an autonomous videoscope that transmits video and is controlled wirelessly from outside the operational space inside the body. This device is the subject of U.S. Pat. No. 8,416,342 to Gitlin et al. and U.S. patent application Ser. No. 13/858,260 to Gitlin et al. In order to achieve the benefits of the proposed family of insertable surgical modules and to place other surgical tools inside the body, an insertion/removal tool is needed to decrease the surgical-tool bottleneck experienced by surgeons in single-site procedures. However, in view of the prior art considered as a whole at the time the present invention was made, it was not obvious to those of ordinary skill in the art how the limitations of the art could be overcome.
Certain attachment tools do exist in the prior art. For example. U.S. Patent Application Publication No. 2005/0267555 to Marnfeldt generally discusses a cannula that is positioned through a patient's skin for access into the interior of the patient to adjust positioning of an already-implanted medical device (as opposed to an insertable and withdrawable device, which tends to be temporary rather than more permanent and has different requirements from the Food and Drug Association). A variety of engagement tools and then be inserted through the cannula to retrieve the implanted medical device, and the engagement tool would then be manually retracted back through the cannula and out of the patient's body. In essence, Marnfeldt discusses a system having two major components (the cannula and the engagement tool) that are not connected to each other in any way.
Marnfeldt further includes a power source for the implanted medical device. In particular, Marnfeldt discusses an implantable stimulator which is a standalone device that is implanted into the patient's body. This implanted stimulator itself includes a power source, programmable memory, electrical circuitry, coil, and a pump. The power source in this implanted stimulator powers the remainder of the device. The implanted stimulator is wirelessly connected to external devices that can send information or power to the implanted stimulator. The power source in Marnfeldt is implanted into the body to power the components within that stimulator. A disadvantage of this methodology is the potential of the RF (i.e., electromagnetic) field to interfere with other devices.
For the internal power source to be recharged by an external source via an RF (electromagnetic) field, the coil of Marnfeldt must be an integral part of the implanted device. As such, there is no electrical or RF field connection between the graspers and the implantable device at any time in Marnfeldt. Further, the graspers taught in Marnfeldt show no ability to conduct electricity or to create an electromagnetic field, and in some configurations are single pieces that are incapable of supplying power, which requires at least two conductors or creation of an electromagnetic field. In other words, the graspers of Marnfeldt have no direct electrical connection with the implantable medical device. Rather, Marnfeldt “transfers power” to the battery of the implantable device via an electromagnetic field that creates an electrical transformer with an air, skin and tissue core, where the primary winding is located in the external source and the secondary winding is the coil which must be located in the implantable device. The use of a transformer requires AC current in the primary coil and results in AC current in the secondary coil. That AC current in the secondary winding/coil requires conversion to DC current via AC-to-DC conversion/rectifier circuitry within the implantable device to power the implantable device. U.S. Pat. No. 6,315,721 to Schulman et al. discusses charging or recharging an implanted/implantable medical device using an AC magnetic device. However, no direct electrical connection is formed, and use of electromagnetic field can potentially interfere with other devices, as previously noted.
As another example, U.S. Patent Application Publication No. 2002/0143355 to Messerly discusses an ultrasonic surgical instrument in a shears-type configuration for cutting targeted tissue. Messerly includes end-effectors that vibrate at ultrasonic frequencies and thus transmit ultrasonic energy to tissues to cut, dissect, or cauterize the tissue. By contrast, the arms and graspers of Applicant's claimed invention are utilized (via the first mechanism) to grab a medical device without cutting, dissecting, or cauterizing the medical device or any associated tissue. A disadvantage of this system, as opposed to the current invention which will become clearer as this specification continues, is that the ultrasonic energy does not power an implantable medical device and the end effectors cannot and must not be powered during insertion and removal of a surgical device. Otherwise, the end effector would be vibrating at ultrasonic frequencies, thus creating an active scalpel.
Accordingly, what is needed is a surgical tool that is capable of accurately positioning and directly powering implantable medical devices. However, in view of the art considered as a whole at the time the present invention was made, it was not obvious to those of ordinary skill in the field of this invention how the shortcomings of the prior art could be overcome.
All referenced publications are incorporated herein by reference in their entirety. Furthermore, where a definition or use of a term in a reference, which is incorporated by reference herein, is inconsistent or contrary to the definition of that term provided herein, the definition of that term provided herein applies and the definition of that term in the reference does not apply.
While certain aspects of conventional technologies have been discussed to facilitate disclosure of the invention, Applicants in no way disclaim these technical aspects, and it is contemplated that the claimed invention may encompass one or more of the conventional technical aspects discussed herein.
The present invention may address one or more of the problems and deficiencies of the prior art discussed above. However, it is contemplated that the invention may prove useful in addressing other problems and deficiencies in a number of technical areas. Therefore, the claimed invention should not necessarily be construed as limited to addressing any of the particular problems or deficiencies discussed herein.
In this specification, where a document, act or item of knowledge is referred to or discussed, this reference or discussion is not an admission that the document, act or item of knowledge or any combination thereof was at the priority date, publicly available, known to the public, part of common general knowledge, or otherwise constitutes prior art under the applicable statutory provisions; or is known to be relevant to an attempt to solve any problem with which this specification is concerned.